Controversies surrounding the use of glycoprotein IIb/IIIa inhibitors.
The use of glycoprotein IIb/IIIa inhibitors reduces morbidity and mortality in patients with acute coronary syndromes and patients undergoing percutaneous coronary intervention. Despite the sound body of evidence that supports the use of these agents, registry data indicate that there is substantial underuse in eligible patients. This may be due to their modest treatment effect, controversy over the significance of reductions in recurrent myocardial infarction, or confusion over appropriate combinations of antiplatelet and antithrombin agents. The challenge for clinicians is to identify patients that receive the most benefit from the use of glycoprotein IIb/IIIa inhibitors. Until the results of ongoing trials become available, the American College of Cardiology/American Heart Association guidelines provide reasonable recommendations on the use of these agents in clinical practice.
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